4 minute read
ALS
ALS BY BEN OWENS
AMYOTROPHIC LATERAL SCLEROSIS
Neurodegenerative diseases like ALS have a significant impact upon quality of life for those diagnosed with the condition. As the body’s neural network is damaged, our minds lose control of their ability to control voluntary, everyday movements like walking, eating, and speaking. 1 New studies on cannabis as a promising treatment option show that cannabis could potentially help in the management of the disease and symptoms like spasticity and cramps—as well as helping to delay disease progression. 2-8 As more research is done on cannabis and conditions like ALS, researchers are hopeful that the endocannabinoid system (ECS) may prove to be a promising route for providing effective treatment. 7,9
WHAT IS ALS? Also known as Lou Gehrig’s disease, ALS is “A progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord.” Discovered in 1869, “ALS usually strikes people between the ages of 40 and 70, and it is estimated there are at least 16,000 Americans who have the disease at any given time.” 1 In the same neurodegenerative diseases family as multiple sclerosis, the damage caused by inflammation and a lack of muscle nourishment leads to scarring and hardening along the spine, which blocks motor neurons, resulting in the brain’s diminished ability to initiate and control muscle movement. This can cause patients to lose the ability to control most voluntary movements. Patients lose the ability to eat, speak, move, and even breathe in some cases.
There are two types of ALS that are most common: sporadic and familial. Familial ALS (FALS) is responsible for less than 10% of all cases in the U.S. and, as the name suggests, is an inherited condition. Sporadic ALS is responsible for the remaining 90-95% of cases and can affect anyone, anywhere—though men are more likely to be diagnosed with disease, and military veterans are twice as likely to be diagnosed with ALS than non-military adults. 1
ALS & CANNABIS: WHAT DOES THE SCIENCE SAY? As more research comes out surrounding cannabis and its effectiveness as a treatment option, we are learning more specifically about how cannabis can be helpful for patients living with ALS. “There is no cure for motor neuron disease, so improved symptom control and quality of life are important for patients,” Dr. Nilo Riva explained. This particular phase II study looked at the efficacy of orally administered cannabinoids in reducing spasticity in 60 adult ALS patients. The study found that, when taken in conjunction with first-line antispasticity drugs, a 1:1 THC:CBD oral solution reduced spasticity in patients when compared to placebo administration. 2,3
Additional studies that have examined the many properties of cannabis as they relate to symptom management for individuals with ALS have proposed that cannabis “Should be considered in the pharmacological management of ALS” due to its applications for “Analgesia, muscle relaxation, bronchodilation, saliva reduction, appetite stimulation, and sleep induction.” 7 While some studies have found no noticeable change in symptoms such as cramps when managing symptoms with THC, other studies suggest that cannabinoids are effective “symptom control agents.” 4,9 Reviews of the existing literature on the ECS as it relates to neurodegenerative diseases like ALS as well as the therapeutic benefits and potential of cannabinoid-therapy suggest that cannabinoids might be effective at managing symptoms as well as having the potential to slow disease progression. 9
Further, cannabinoids are being found to not only help with symptom management but also the underlying causes of ALS. “Two of the primary hypotheses underlying motor neuron vulnerability are susceptibility to excitotoxicity and oxidative damage,” Dr. Chandrasekaran Raman, lead researcher of one such study, explains. “There is rapidly emerging evidence that the cannabinoid receptor system has the potential to reduce both excitotoxic and oxidative cell damage.” 6 Dr. Raman’s study involved mice and investigated the efficacy of THC administration before and after symptom onset. It found THC was able to delay motor impairment and prolong survival when administered at the onset of tremors. Additionally, the study noted THC was anti-excitotoxic when administered in vitro, and in vitro administration was “Extremely effective at reducing oxidative damage in spinal cord cultures.” 6 Further studies have found that cannabinoids like THC that bind with CB1 receptors help with the inflammation that causes neurodegeneration, and cannabinoids like CBD that bind with CB2 receptors actually help to delay the progression of the disease itself. 8
If you’re one of the more than 16,000 people in the U.S. living with ALS, or know someone who is, consider the available information on cannabis’ efficacy at both managing symptoms as well as delaying disease progression. Oral and IV administration are among the most studied administration routes, and current findings suggest that administration involving equal parts THC and CBD might prove beneficial over THC-only administration. 1-4,6-8 Before beginning any cannabis treatment, talk with your doctor about current research and ask about how cannabis could be incorporated into your current treatment plan.
